If you have just recently been diagnosed with endometriosis, then this blog is definitely for you! As an OBGYN, I find it is so important to share as much information as I can so you don’t ever feel in the dark. Endometriosis can definitely be confusing and sometimes a slow process to diagnose and treat, so I wanted to break down everything I know to help you guys in your journey. If you have any questions at all, please leave them in the comments and I promise to answer them when I can. Now let’s get to it…
The What & Where:
Endometriosis is a condition in which the type of tissue that forms the lining of the uterus (the endometrium) is found outside the uterus. Endometriosis actually affects 1 in 10 women of reproductive age.
Areas of endometrial tissue (often called implants) most often occur in the following places: peritoneum (lining of the abdomen), ovaries, fallopian tubes, outer surfaces of the uterus, bladder, ureters, intestines & rectum.
The Problem:
The implants may grow and bleed like the uterine lining does during the menstrual cycle. Surrounding tissue can become irritated, inflamed & swollen. This can cause adhesions (scar tissue) to form which can cause organs to stick together. The bleeding, inflammation, and scarring can cause pain, especially before and during menstruation.
The Pain & Symptoms:
The number one symptom is pelvic pain and cramps may last for days around the time of your period, alongside pain in your lower back or stomach. Women may also experience pain during or after sex and can also find it painful to go to the bathroom.
Many ladies also experience either extremely heavy periods or bleeding in between their periods. Fatigue is very common, as well as, digestive issues such as diarrhea, constipation, bloating, or nausea All of these tend to be around your period, but can also be experienced outside of that time frame also.
Infertility Info:
Infertility is usually a large concern with women diagnosed with Endo. About 40% of women with infertility have endometriosis, so there is definitely a correlation. Why does that happen? Inflammation from endometriosis may damage the sperm or egg or interfere with its movement through the fallopian tubes and uterus. In severe cases of endometriosis, the fallopian tubes may be blocked by adhesions (scar tissue). But, not everyone with Endometriosis has fertility issues, it’s just something to be aware of so you can be proactive.
Diagnosis:
As providers, we clinically diagnose endometriosis based on patient history & physical exam/pelvic exam. But the only way to definitively diagnose is by having a surgical procedure called laparoscopy, where we can look inside the abdomen and obtain a biopsy of the implants.
Treatment Options:
This can be different for everyone and depends on the extent of the disease, your symptoms, and whether you want to have kids. Endometriosis may be treated with medication, surgery, or both. When pain is the primary problem, medication usually is tried first. Pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), and hormonal medications, including birth control pills, progestin-only medications, and gonadotropin-releasing hormone agonists. Hormonal medications help slow the growth of the endometrial tissue and may keep new adhesions from forming.
Surgery is the second option and can be done to relieve pain and improve fertility. During surgery, endometriosis implants can be removed. After surgery, most women have relief from pain, but there is a chance the pain will come back. About 40–80% of women have pain again within 2 years of surgery. Taking birth control pills or other medications after having surgery may help extend the pain-free period.
